NPIMap

Organization Active NPI

Lac/Usc Vip Clinic

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1134445257
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18548 Issued in CA
Legal business name
LAC/USC VIP CLINIC
Practice address
2010 Zonal Ave.
Opd 3P61
Los Angeles, CA 90033
Phone
(323) 226-3961
Fax
(323) 226-2573
NPI assigned
Apr 14, 2010
Last updated
Apr 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jennifer Perez, M.P.A.
Title
Program Manager
Phone
(323) 226-5217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 18548 CA Primary

Addresses

Primary practice location

2010 Zonal Ave.
Opd 3P61
Los Angeles, CA 90033

Mailing address

2010 Zonal Ave.
Opd 3P61
Los Angeles, CA 90033
Phone (323) 226-3961

National Provider Directory

National Provider Directory
Tax ID family
Rancho Los Amigos Liver613 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2010 Zonal Ave
#3P61
Los Angeles, CA 90033
Phone (323) 226-3961

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1134445257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE.",
            "address_2": "OPD 3P61",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-226-3961",
            "fax_number": "323-226-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE.",
            "address_2": "OPD 3P61",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-226-3961",
            "fax_number": "323-226-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAC/USC VIP CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "323-226-5217",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.P.A."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.